Maternal and neonatal outcomes associated with illness severity of maternal COVID-19.

BACKGROUND: Several reports demonstrated that perinatal SARS-CoV-2 has significant impact on maternal and neonatal health outcomes. However, the relationship between severity of maternal illness with outcomes remains less clear. METHODS: This is a single-center retrospective cohort study of mother/infant dyads with positive maternal test for SARS-CoV-2 between 14 days prior and 3 days after delivery from 3/30/2020 to 12/28/2021. RESULTS: Among 538 mothers, those with moderate/severe/critical illness were more likely to undergo induction, receive oxygen, mechanical ventilation or ECMO. Mortality was significantly higher among the mothers with severe illness than asymptomatic and those with mild illness (6% vs 0% and 0%, respectively, P < 0.05). Neonates born to mothers with moderate/severe/critical illness were more likely to be preterm with lower birth weight, and to be admitted to the NICU (P < 0.05) but not to be small for gestational age. Mild maternal illness was only associated with NICU admission for isolation precaution and decreased rate of breastfeeding. CONCLUSIONS: Maternal illness severity was significantly associated with prematurity and several adverse maternal and neonatal outcomes.

Evaluation of a patient education program for chronic obstructive pulmonary disease.

An audiovisual instructional program for patients with chronic obstructive pulmonary disease was evaluated in 65 patients with this disease and 20 patients without lung disease. We found that the program was successful in increasing the factual knowledge about chronic obstructive pulmonary disease, with the attainment of mean scores of 88 and 95% on postteaching tests. Patients with varying educational backgrounds achieved similar gains in knowledge.

Hypocomplementemic urticarial vasculitis: association with chronic obstructive pulmonary disease.

Since 1973, we have identified and collected follow-up data on 16 patients with hypocomplementemic urticarial vasculitis. Preliminary diagnostic criteria are the presence of typical urticarial skin lesions and low levels of serum complement (all components), plus two of the following: dermal venulitis, arthritis, glomerulo-nephritis, episcleritis or uveitis, recurrent abdominal pain, and C1q precipitin in plasma. Exclusions are systemic lupus erythematosus, mixed cryoglobulinemia, elevated antinuclear antibody titer, hereditary deficiency of a complement component or of C1 esterase inhibitor, and presence of anti-native DNA or hepatitis B antigen. The renal involvement is relatively benign, and generally the patients do well and respond to specific treatment when this is indicated. Eight of 10 smokers studied had evidence of chronic obstructive pulmonary disease, 1 of whom died of this complication. In three patients, severe chronic obstructive pulmonary disease developed at a young age after relatively low pack-year cigarette smoking histories. Lung disease probably results from the interaction of two major risk factors-smoking and an immunologically mediated process that has not been identified.

150 years of the New York Academy of Medicine: a series of exhibitions.

As the New York Academy of Medicine celebrates its 150th year as a leader in the field of urban health, it is instructive to review the events and decisions that influenced and shaped it. Since its inception, the Academy has taken an active role in lobbying state and local governments to enact more-effective public health laws and in educating the public about improving health conditions. During 1996 and 1997, the Academy Library's Historical Collections is mounting a series of six exhibitions that are intended to tell the story of public health in New York as influenced by the New York Academy of Medicine. The story will be told using printed books, pamphlets, posters, photographs, and manuscripts drawn from the Library's collections, as well as the Academy's archives. Each exhibition will highlight the Academy's accomplishments in the subject areas presented. In this article, we summarize all six of the exhibitions and offer an in-depth look at the first two exhibitions.

alpha1-Antitrypsin deficiency in nonsmokers.

The clinical symptoms, measurements of pulmonary function, and interpretations of thoracic roentgenograms in 18 patients with alpha1-antitrypsin deficiency associated with the PiZ phenotype are reported. The patients had never smoked and had little or no exposure to occupational and urban air pollution. The findings were compared with those in a group of patients who also had the PiZ phenotype, but who were smokers. The results showed that the clinical course, rate of pulmonary-function deterioration, and appearance of the thoracic roentgenograms in persons who had never smoked are variable and suggested that other factors, in addition to phenotype and environmental pollutants, are determinants of the chronic obstructive pulmonary disease that develops in these patients. Many of these patients lived into their sixth and seventh decades, suggesting that those patients who avoid respiratory irritants do not necessarily have an ominous prognosis. These are important considerations in the diagnosis and treatment of patients who have this deficiency.